Contemporary experience in management of squamous cell carcinoma of the penis in Hong Kong: lessons learned over 20 years

Abstract

Objective:

Squamous cell carcinoma of the penis(SCCp) is a rare malignancy. Optimal management of primary tumour and nodal disease remains challenging. This study aims to provide a contemporary perspective to its current management in Hong Kong.

Patients and Methods:

A retrospective analysis of histologically proven SCCp patients between January 1997 to July 2017 at three institutions was performed. Patient demographics, clinical features, treatment approach for primary tumour, nodal management, clinical and pathological outcomes were analyzed.

Results:

Ninety‐three patients (aged 34–94) were eligible for study. Mean time from development of symptoms to presentation was 9 months. Of the 80 who received surgery for primary tumour, 74 (93%) had partial or radical penectomy. 59 (63%) of patients had ≤T2 on final histopathology, potentially eligible for organ‐preserving surgery. Despite poor sensitivity, CT was the most common imaging modality for nodal staging. 24 (26%) patients had pN+ disease. With median follow‐up of 111 months, 32 (34%) patients died of SCCp.

Conclusion:

SCCp patients in Hong Kong often delay presentation to urologists, and is associated with high mortality rate. Partial or radical penectomy were the commonest surgical options, although most had ≤T2 and eligible for organ‐preserving surgery. Many patients underwent inguinal lymphadenectomy unnecessarily. Development of a risk‐adopted strategy with dynamic sentinel lymph node evaluation is needed.